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Physical, Cognitive, and Psychosocial Variables From the Disablement Process Model Predict Patterns of Independence and the Transition Into Disability for the Oldest-Old

Correspondence: Address correspondence to Elizabeth Braungart Fauth, PhD, Department of Family, Consumer, and Human Development, Utah State University, 2905 Old Main Hill, Logan, UT 84322-2905. E-mail: efauth{at}cc.usu.edu

Purpose: This study used the Disablement Process Model to predict whether a sample of the oldest-old maintained their disability or disability-free status over a 2- and 4-year follow-up, or whether they transitioned into a state of disability during this time. Design and Methods: We followed a sample of 149 Swedish adults who were 86 years of age or older over a period of 4 years; we grouped them by ability in activities of daily living as being functional survivors (nondisabled over time), increasingly disabled (initially nondisabled but later disabled), chronically disabled (disabled at all waves), or deceased. We used variables from baseline to predict group membership into these four longitudinal outcome groups.  Results: Results indicated that demographic factors, physical impairments, physical and cognitive limitations, and psychosocial variables at baseline predicted membership into the functional survivor group after 2 years and most continued to distinguish between functional survivors and other groups after 4 years. Implications: These findings indicate key variables that may be useful in predicting shorter term longitudinal changes in disability. By understanding the physical, cognitive, and psychological variables that predict whether a person develops a disability within the next 2 or 4 years, we may be better able to plan for care or implement appropriate interventions.

Key Words: Disability trajectories • Late-life functioning • Oldest-old • Predictors of disability